Patient-Reported Benefits and Limitations of Mobile Health Technologies for Diabetes in Pregnancy: Protocol for a Scoping Review

Background For women with pre-existing and gestational diabetes mellitus, pregnancy involves specialized and intensive medical care to improve maternal and infant outcomes. Medical management for patients with diabetes in pregnancy typically occurs via frequent face-to-face outpatient appointments. Barriers to face-to-face care during the COVID-19 pandemic have signaled the need for high-quality, patient-centered virtual health care modalities, such as mobile health (mHealth). Objective The objective of the proposed scoping review is to identify the patient-reported benefits and limitations of mHealth technology among women with diabetes in pregnancy. We also aim to determine how the women’s experiences align with the best practice standards for patient-centered communication. Methods Arksey and O’Malley’s framework for conducting scoping reviews with refinements by Levac et al will be used to guide the conduct of this scoping review. Relevant studies will be identified through comprehensive database searches of MEDLINE, Embase, Emcare, and PsycINFO. Following database searches, studies will be screened for eligibility at the title, abstract, and full-text level by two independent reviewers, with the inclusion of a third reviewer if required to reach consensus. Data charting of included studies will be conducted by one reviewer using a standardized data extraction form and verified independently by a second reviewer. Synthesis of results will be guided by Thomas and Harden’s “Methods for the Thematic Synthesis of Qualitative Research in Systematic Reviews.” Results As of August 2020, we have carried out the qualitative searches in the electronic databases MEDLINE, Embase, Emcare, and PsycINFO (Ovid interface) for a combined total of 8207 articles. Next, we plan to conduct the quantitative searches in the electronic databases MEDLINE, Embase, and Emcare (Ovid interface). We also plan to review the reference lists of relevant studies to identify additional eligible studies. Conclusions With the results of this review, we hope to describe the patient-reported benefits and limitations of mHealth technology for women with diabetes in pregnancy. Furthermore, we aim to determine how women’s experiences align with the best practice standards for patient-centered communication. Ultimately, our review can provide valuable information for guideline developers, policy makers, and clinicians related to mobile technologies to support virtual care delivery for women with diabetes in pregnancy. International Registered Report Identifier (IRRID) PRR1-10.2196/29727

A randomized controlled trial of an mHealth intervention for increasing access to HIV testing and care among young cisgender men and transgender women: the mLab App study protocol

Background The number of youth living with HIV in the United States (US) continues to rise, and racial, ethnic, and sexual minority youth including young men who have sex with men (YMSM) and young transgender women (YTGW) bear a disproportionate burden of the HIV epidemic. Due to social and healthcare system factors, many YMSM and YTGW do not seek HIV testing services and are therefore less likely to be aware that they are infected. Mobile health technology (mHealth) has the ability to increase uptake of HIV testing among these populations. Thus, the mLab App—which combines HIV prevention information with a mobile phone imaging feature for interpreting at-home HIV test results—was developed to improve testing rates and linkage to care among Black, Latino, and other YMSM and YTGW living in New York City and Chicago and their surrounding areas. Methods This study is a three-arm randomized controlled trial among YMSM and YTGW aged 18–29 years. Participants are randomized to either the mLab App intervention including HIV home test kits and standard of preventive care, standard of preventive care only, or HIV home test kits and standard of preventive care only. Discussion mHealth technology used for HIV prevention is capable of delivering interventions in real-time, which creates an opportunity to remotely reach users across the country to strengthen their HIV care continuum engagement and treatment outcomes. Specifically during the COVID-19 pandemic, mHealth technology combined with at-home testing may prove to be essential in increasing HIV testing rates, especially among populations at high-risk or without regular access to HIV testing. Trial registration This trial was registered with Clinicaltrials.gov (NCT03803683) on January 14, 2019.

The use of mobile health technology in the management of osteoarthritis: a scoping review with scientometric analysis (Preprint)

BACKGROUND Globally, hip and knee osteoarthritis (OA) are ranked as the eleventh most common cause of disability among adults. Growing evidence suggests that the use of mHealth technology in OA management is effective and reduces the burdens in primary and secondary care. However, a comprehensive state-of-the-art review on the use of mHealth technology in managing OA is lacking. OBJECTIVE This review aimed to assess the current state of research on the use of mHealth technology for self-management/education of adults with OA, identify key research activities, and provide future directions on the development/application of mHealth technology. METHODS The Arksey and O’Malley methodological framework was employed, augmented with a scientometric analysis using VOS viewer. Six databases were searched from inception to 31st March 2021. The PRISMA extension for scoping review was used to report the findings. RESULTS Our review only identified 19 mHealth programs being used to promote self-management of OA. The current evidence suggested that compared to no or other interventions, mHealth technology was feasible and might be more effective in reducing pain, or promoting physical function and quality of life in individuals with OA. However, not all mHealth programs were developed by healthcare professionals. The scientometric analysis revealed various co-occurring keywords that reflected conceptual properties of this research domain. Although some intellectual connections among groups of authors, research articles, and journals were also noted, only a few researchers and journals were the most impactful contributors in this research domain. CONCLUSIONS The use of mHealth technology in OA management is potentially promising, however, there is a great need to investigate the benefits and cost-effectiveness of this approach. More collaborations among organizations are warranted to bolster activity in this area. Future mHealth programs should be developed based on a strong theoretical background to support the uptake of their programs. CLINICALTRIAL Nil

Optimizing community linkage to care and antiretroviral therapy Initiation: Lessons from the Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS) and their adaptation in Nigeria ART Surge

Background Ineffective linkage to care (LTC) is a known challenge for community HIV testing. To overcome this challenge, a robust linkage to care strategy was adopted by the 2018 Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS). The NAIIS linkage to care strategy was further adapted to improve Nigeria’s programmatic efforts to achieve the 1st 90 as part of the Nigeria Antiretroviral Therapy (ART) Surge initiative, which also included targeted community testing. In this paper we provide an overview of the NAIIS LTC strategy and describe the impact of this strategy on both the NAIIS and the Surge initiatives. Methods The NAIIS collaborated with community-based organizations (CBOs) and deployed mobile health (mHealth) technology with real-time dashboards to manage and optimize community LTC for people living with HIV (PLHIV) diagnosed during the survey. In NAIIS, CBOs’ role was to facilitate linkage of identified PLHIV in community to facility of their choice. For the ART Surge, we modified the NAIIS LTC strategy by empowering both CBOs and mobile community teams as responsible for not only active LTC but also for community testing, ART initiation, and retention in care. Results Of the 2,739 PLHIV 15 years and above identified in NAIIS, 1,975 (72.1%) were either unaware of their HIV-positive status (N = 1890) or were aware of their HIV-positive status but not receiving treatment (N = 85). Of these, 1,342 (67.9%) were linked to care, of which 952 (70.9%) were initiated on ART. Among 1,890 newly diagnosed PLHIV, 1,278 (67.6%) were linked to care, 33.7% self-linked and 66.3% were linked by CBOs. Among 85 known PLHIV not on treatment, 64 (75.3%) were linked; 32.8% self-linked and 67.2% were linked by a CBO. In the ART Surge, LTC and treatment initiation rates were 98% and 100%, respectively. Three-month retention for monthly treatment initiation cohorts improved from 76% to 90% over 6 months. Conclusions Active LTC strategies by local CBOs and mobile community teams improved LTC and ART initiation in the ART Surge initiative. The use of mHealth technology resulted in timely and accurate documentation of results in NAIIS. By deploying mHealth in addition to active LTC, CBOs and mobile community teams could effectively scale up ART with real-time documentation of client-level outcomes.

Scoping review: the empowerment of Alzheimer’s Disease caregivers with mHealth applications

Alzheimer’s Disease (AD) is one of the most prevalent neurodegenerative chronic diseases. As it progresses, patients become increasingly dependent, and their caregivers are burdened with the increasing demand for managing their care. Mobile health (mHealth) technology, such as smartphone applications, can support the need of these caregivers. This paper examines the published academic literature of mHealth applications that support the caregivers of AD patients. Following the PRISMA for scoping reviews, we searched published literature in five electronic databases between January 2014 and January 2021. Twelve articles were included in the final review. Six themes emerged based on the functionalities provided by the reviewed applications for caregivers. They are tracking, task management, monitoring, caregiver mental support, education, and caregiver communication platform. The review revealed that mHealth applications for AD patients’ caregivers are inadequate. There is an opportunity for industry, government, and academia to fill the unmet need of these caregiver.

Viewing mHealth Technology Design through the Lens of Amplification Theory (Preprint)

BACKGROUND Heart disease is a leading cause of death in the United States (U.S.), killing roughly 655,000 Americans each year. It also represents a disproportionate harm to minoritized people, who often face structural barriers to health including poor access to emergency medical services and treatment, insurance coverage, healthy foods, and safe environments for physical activity. Researchers and providers studying racial health disparities in cardiovascular disease treatment and outcomes use SMS text messaging to facilitate communication between providers and patients, electronic home blood pressure monitors to enable the tracking of trends in blood pressure readings over time, and wearable devices like the Fitbit and Apple Watch to monitor health metrics like heart rate, exercise, and cardiac electrical activity. This viewpoint argues that access to these technologies does not guarantee the ability to afford or sustainably use them; it is merely one precondition of technology use that providers and researchers should consider when designing technological interventions to address patient needs. OBJECTIVE This paper provides a model that interventionist health services researchers can follow in order to think about facilitators of and barriers to technology use among patients whose resource constraints may shape their capacity to address the modifiable cardiovascular disease risk factors that these technologies target. METHODS This Viewpoint offers reflections on an ongoing community-based participatory research design process in developing an mHealth intervention into hypertension management. RESULTS Results presented included a model that interventionist health services researchers can follow to improve research design. CONCLUSIONS Structural barriers to mHealth technology use must be addressed at every stage of the research process, and must guide decision-making about how providers and researchers can work with community partners to ensure that patients and community partners have the capability to use technological interventions as designed.

Faktor Yang Mempengaruhi Keberlanjutan Minat Pengguna Dalam Menggunakan Aplikasi Mhealth Melalui Variabel Satisfaction

The use of internet and smartphone has evolved. The rapid growth of innovation in technology allows them to become a high-functioning service provider through many of the applications available to help out humans fulfilling their needs. People demand quick and instant service provision, including health service. Applications based on mHealth technology are made to serve that demand. This research aims to examine the effects of intervening variables such as perceived usefulness, perceived ease of use, trust in application, and satisfaction on consumers’ continuance intention to use mHealth technology. This research employs a quantitative method to assess primary data samples taken from the users of Halodoc health service application in Java. The results of this research show that the trust and perceived usefulness variables do not significantly affect consumers’ continuance usage intention. Only the perceived ease of use and satisfaction variables yield a significant impact on consumers’ continuance usage intention. Hopefully, these results can be a valuable insight for PT Media Dokter Investama to enhance their service to attract more mHealth technology users to use Halodoc.